The authors present here one of the most extensive Rorschach studies to date of people between the ages of 70 and 100. They establish a gradient of responses in older subjects from normal adult performance, through a presenile level, to senility. The material is presented in concrete fashion, with specific "signs" as well as typical scores of presenility and senility, and with many complete records typical of each level of performance.

This guide is a much-needed reference for clinicians on how to use the Rorschach Inkblot Test with senior adults, an essential tool for assessing personality functioning to better identify psychological interventions. The book integrates historical developments, current research, conceptual considerations, and therapeutic and diagnostic applications. Chapters review basic guidelines for the understanding and interpretation of Rorschach variables, including protocol validity; interpretation of structural variables, thematic imagery, and cross-cultural normative data; sequence analysis; and more. The authors then provide 10 case illustrations of how the Rorschach indices of cognitive functioning, emotional experience, interpersonal relatedness, and self-perception can facilitate differential diagnosis and treatment planning in clinical work with older people. These case illustrations are rooted in previously non-existent Rorschach reference data based on an international sample of more than 250 senior adults and a second sample of more than 200 patients with Alzheimer’s disease. Clinicians will come away with a solid empirical basis for distinguishing between normal-range personality functioning and manifestations of psychological disorder in the elderly and for providing beneficial interventions to senior adult patients.

It has been estimated that there are at least 2,500,000 adults, 10% of the population above age 65, who are currently in need of some sort of mental health services (Kramer, Taube, and Redick, 1973). Other estimates are even higher (e. g. , Pfeiffer, 1977). It is expected that this number will increase as the number of older adults increases over the next 40 years. Probably less than 400 clinical psychologists are now provid ing services to this age group. The number of elderly patients actually seen by these psychologists is very, very small. One national survey found that of 353 psychologists who reported that they had older clients, only 495 individuals were seen for psycho logical testing and 1423 for psychotherapy in the one month just prior to the response (Dye, in press). Assuming that the same in dividuals were not seen for both testing and therapy within the one month period--a questionable assumption--approximately . 08% of the at least two-and-one-half million older adults in need of psychological services are now being supplied with these services in some form or another. Thus, the need for increased involvement of clinical psychology with the aged is undeniable. However, few resources currently exist which will serve to increase the number of clinical psychologists trained to meet this need. Probably less than 100 clinical psychologists living today have received any kind of formal graduate training in the clinical psychology of the aging (Storandt, 1977).

Experimental gerontopsychology attempts to test causal hypotheses about old age-related behavioral changes by the manipulation of age-differences. An experimental treatment is introduced with the purpose of equating different age-groups with respect to a potentially relevant function. If the treatment results in an assimilation of the behavior of the different age-groups (age by-treatment interaction), differences in this function are con sidered as causal for the normally observed behavioral differ ence. If it does not result in an assimilation of the behavior of the different age-groups (main effect of treatment), differ ences in this function are considered as irrelevant for the nor mally observed behavioral difference. The different interpretations of age-by-treatment interactions and main effects of treatment in this kind of research are reasonable only if the experimental treatment actually results in an equalization of the age-groups with respect to the func tion of interest. As is shown, such a functional equalization can neither be demonstrated nor assumed in many cases. In such cases, studies with either age-group can be used to investigate hypotheses about potential causes for old age-related behavioral changes, studies with young subjects having important advantages over studies with old subjects. A test of causal relationships by age-by-treatment interactions is possible in cases where the experimental treatment evidently results in an equalization of the age groups with respect to the function in question. Unfortunately, the field of application for this kind of approach is rather limited.

Here is a major text in psychogeriatrics for all professionals in the field of aging and mental health. Leading authorities provide valuable insights into assessment and intervention techniques for use with the mentally impaired elderly. Topics include a depression scale for use in later life, family therapy, therapy in later life, and various issues concerning mental health care for the aged.